The gut microbiota as a promising therapeutic target in Anorexia Nervosa: A systematic review

Introduction & Objective: Anorexia nervosa (AN) has severe, multisystemic, acute complications with high morbidity and mortality rate. Microbiota homeostasis is crucial for healthy communication between the gut and the nervous system. In this Review, we discuss the gut microbiota as a promising therapeutic target in AN.Methods: This review article was performed within articles published at PubMed, Science Direct, Google Scholar, SID, and Cochrane until December ۲۰۲۲. The keywords were anorexia nervosa, gut microbiota, probiotics and treatment. By searching these databases; ۸۹ articles were found, ۳۱ of them by Reading titles and abstracts were removed. ۵۸ articles were selected under the inclusion criteria.Results: Finally, ۵۸ articles were included in the study. The gut-brain axis revealed that the gut microbiome might be a vital pathway for mental and cognitive health. Gut microbiota could control appetite sensation via neural pathways and its dysbiosis played an essential role in the maintenance of AN. Short-chain fatty acids (SCFAs) such as acetate and propionate produced by gut microbiota fermentation of dietary fibers and resistant starch increased the satiety-enhancing properties of food. In AN patients total SCFAs diminished. Roseburia, Ruminococcus, and Clostridium were reduced. Probiotics Including Lactobacillus reuteri DSM ۱۷۹۳۸ contributed to the faster nutritional recovery in childhood AN. Lactobacillus johnsonii and Lactobacillus reuteri could upregulate the hormone oxytocin and Bifidobacterium adolescentis as a vital member of the human gut microbiota in the production of GABA to achieve mental health. AN Patients had decreased levels of serotonin, GABA, dopamine, and acetate compared to controls. Butyrate-producing species such as Verrucomicrobia and Bifidobacteria decreased and mucine-degrading species increased in AN. Decreased availability of colonic butyrate could lead to an Inflammation-mediated disruption of the intestinal barrier. Gut microbiota alterations observed in AN might contribute to increased intestinal permeability that facilitated the translocation of bacterial metabolites into the systemic circulation. This led to low-grade inflammation.Conclusion: It seems that gut microbiota composition and function may have implications for developing microbiome-based prevention, diagnostics, and therapeutics for AN.

کلیدواژه ها:

Anorexia nervosa ، gut microbiota ، treatment ، probiotics ، gut-brain axis